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Re: [FH] Re: food dilemma

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  • Linda Fischbach
    Dana, if you need to give a phosphorus binder, you can buy containers of aluminum hydroxide dried gel powder, which is tasteless and odorless
    Message 1 of 12 , Jan 3, 2006
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      Dana, if you need to give a phosphorus binder, you can buy containers of
      aluminum hydroxide dried gel powder, which is tasteless and odorless
      http://members.verizon.net/~vze2r6qt/supplies/binders.htm.

      Remember that phosphorus should be below 6, and as close to 4 as possible.

      Linda

      ----- Original Message -----
      From: "Dana McCormick" <danamcmk@...>
      To: <feline-heart@yahoogroups.com>
      Sent: Tuesday, January 03, 2006 12:52 PM
      Subject: RE: [FH] Re: food dilemma


      > Linda,
      >
      > As a parent to 2 kidney kitties & lucky parent to 1
      > kidney transplant kitty, I can tell you it's best to
      > feed the protein restricted food. My Creampuff lived
      > w/ CRF for 6.5 yrs & was on Hills K/D dry, she
      > wouldn't eat the canned. I firmly believe she
      > wouldn't have done so well for so long with a regular
      > food. My Mouse also ate this, again, wouldn't eat the
      > canned. They didn't love the food, but ate it. The
      > reason you need this type of food is because it allows
      > the kidneys to not have to work so hard. There is some
      > debate on this issue, but all the kidney specialists
      > I've spoken to go with the low protein theory.
      > Mousie's surgeon & the other surgeons in this very
      > limited field also go w/ the low protein & I would say
      > their opinions are very relevant. What's Pumpkin's
      > creatinine, BUN & PCV?
      >
      > Creampuff got Alternagel as a phosphorous binder,
      > Mousie never needed it.
      >
      > Feel free to drop a line if you need more info.
      >
      > Dana
    • savionna@aol.com
      Hi Linda, In a message dated 1/3/06 10:38:08 AM, fischbl@earthlink.net writes:
      Message 2 of 12 , Jan 4, 2006
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        Hi Linda,

        In a message dated 1/3/06 10:38:08 AM, fischbl@... writes:

        << I agree that a cat in early CRF does not need a low protein diet, but I
        have

        to disagree about the phosphorus. >>

        I think we also agree about phosphorus...but I didn't express myself clearly
        in this complex issue. So thanks for picking up on this.

        << As far as I know, there is no debate about that feeding CRF cats a low

        phosphorus diet is better, even in early CRF. >>

        I agree. But a diet with a "low" level of phosphorus is appropriate for all
        cats...healthy, CRF, or cardiac...which is why I didn't call it out (but in
        retrospect should have). I think part of the muddle may be with the definition of
        "low."

        To back up a little...mineral levels and balance are important for all cats,
        esp the balance between phosphorus and calcium. And it's not a good idea for
        any cat to regularly eat a "high" amt of phosphorus (like over
        300-400mg/100kcal), even if it is balanced with calcium. The current recommendation is that a
        healthy adult cat needs about 65-70mg phosphorus per kg body weight. So the
        average 10 lb cat (4.5kg) needs about 300mg phosphorus daily.

        Many of the commercial foods with higher-quality nutrition (eg Wellness,
        Nature's Variety, Felidae, PetGuard) have flavors with about 1% phosphorus DM or
        about/under 200mg/100kcal. If the average healthy 10-lb adult cat eats 200
        calories of that food per day (to meet the average calorie requirement of 20
        cal/lb/day), then he's getting about/under 400mg phosphorus. (By comparison,
        typical prey animals...eg mouse, rat, rabbit, bird...have about 2-3% phosphorus DM
        or about 200-300mg/100kcal.)

        So is about 1% DM or 200mg/kcal low enough? (I thought it was.) Or do you
        think a more severe restriction (like about 0.5% DM or 100mg/100kcal) is more
        appropriate for a cat with elevated creatinine (which may indicate early kidney
        insufficiency, tho I wasn't clear whether Linda's cat has CRF)? Are cats with
        very restricted phosphorus intake at greater risk for metabolic acidosis and/or
        anemia?

        << Keeping the cat's phosphorus

        level as close to 4 as possible is important. >>

        Yes. A blood level around 4 mg/dL is important for all cats. Do you think
        feeding a product with around 1% phosphorus DM would adversely affect the blood
        phosphorus level for most cats?

        << Interestingly, cooked skinless chicken thighs (obviously high in protein)

        have about the same amount of phosphorus per 100 calories as K/D has per 100

        calories. >>

        Also interesting is that cooked skinless chicken thighs contain about twice
        as much protein as k/d. 100kcal thighs = about 12.5g protein and 85mg
        phosphorus. 100kcal k/d = about 6.5g protein and 80mg phosphorus.

        And just to follow up on the low-protein issue for those juggling kidney and
        heart disorders...there are a number of articles that cover the evolution of
        the reduced-protein theory and why it's now considered inappropriate. They are
        mostly about dogs, but the information is by and large applicable to cats, who
        have a higher dietary protein requirement than do dogs and an essential need
        for certain amino acids. (The first 2 had disappeared from the net for a
        while, but are now available again in PDF format; click on the link below, then
        scroll to find the hot link for the article titles):

        1. "Mythology of Protein Restriction for Dogs with Reduced Renal Function,"
        by Kenneth Bovee, DVM, MMedSc (UPenn) at
        http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm

        2. "Effects of Dietary Protein Intake on Renal Functions," by Delmar Finco,
        DVM, PhD (Univ of Ga) at
        http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm

        3. "Dietary Protein and the Kidney" by Patricia Schenck, DVM, PhD (Michigan
        State Univ) at
        http://web.archive.org/web/20040205075757/http://www.cm-d.com/buckeye/tech_manual/8_28.html

        4. www.dogaware.com/kidney.html

        // Rosemary
      • Linda Fischbach
        Rosemary, I saved this and then never answered you. For a cat with CRF, a lower phosphorus died is best. 1%DM is really the highest one should feed, but 1%
        Message 3 of 12 , Jan 5, 2006
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          Rosemary, I saved this and then never answered you. For a cat with CRF, a
          lower phosphorus died is best. 1%DM is really the highest one should feed,
          but 1% really isn't that low. The kidneys usually remove the phosphorus
          from the blood, but as CRF advances, the kidneys are more and more
          inefficient about removing the phosphorus, so it tends to increase in the
          blood.

          With advanced CRF, a cat can have a phosphorus level of 10-20, even eating
          very low phosphorus food. So phosphorus binders (aluminum hydroxide) are
          used to bind even the small amount that is eaten. Most peope use binders
          when a CRF cat's phosphorus gets above 6.

          I lost my first CRF cat in 2000; Mittens and Topaz, who both had CRF, died
          last year, but not from CRF. I fed Mittens and Topaz a moderately high
          protein diet, but as low in phosphorus as K/D. They also had some binders
          and their phosphorus level stayed close to 4.

          Now I have one cat with early CRF. I've been a member of CRF Support for
          over 6 years, and a mod for 5. And I own the Phosphorus Management group.

          Linda

          ----- Original Message -----
          From: <Savionna@...>
          To: <feline-heart@yahoogroups.com>; <fischbl@...>
          Sent: Wednesday, January 04, 2006 11:26 AM
          Subject: Re: [FH] Re: food dilemma


          > Hi Linda,
          >
          > In a message dated 1/3/06 10:38:08 AM, fischbl@... writes:
          >
          > << I agree that a cat in early CRF does not need a low protein diet, but I
          > have
          >
          > to disagree about the phosphorus. >>
          >
          > I think we also agree about phosphorus...but I didn't express myself
          > clearly
          > in this complex issue. So thanks for picking up on this.
          >
          > << As far as I know, there is no debate about that feeding CRF cats a low
          >
          > phosphorus diet is better, even in early CRF. >>
          >
          > I agree. But a diet with a "low" level of phosphorus is appropriate for
          > all
          > cats...healthy, CRF, or cardiac...which is why I didn't call it out (but
          > in
          > retrospect should have). I think part of the muddle may be with the
          > definition of
          > "low."
          >
          > To back up a little...mineral levels and balance are important for all
          > cats,
          > esp the balance between phosphorus and calcium. And it's not a good idea
          > for
          > any cat to regularly eat a "high" amt of phosphorus (like over
          > 300-400mg/100kcal), even if it is balanced with calcium. The current
          > recommendation is that a
          > healthy adult cat needs about 65-70mg phosphorus per kg body weight. So
          > the
          > average 10 lb cat (4.5kg) needs about 300mg phosphorus daily.
          >
          > Many of the commercial foods with higher-quality nutrition (eg Wellness,
          > Nature's Variety, Felidae, PetGuard) have flavors with about 1% phosphorus
          > DM or
          > about/under 200mg/100kcal. If the average healthy 10-lb adult cat eats 200
          > calories of that food per day (to meet the average calorie requirement of
          > 20
          > cal/lb/day), then he's getting about/under 400mg phosphorus. (By
          > comparison,
          > typical prey animals...eg mouse, rat, rabbit, bird...have about 2-3%
          > phosphorus DM
          > or about 200-300mg/100kcal.)
          >
          > So is about 1% DM or 200mg/kcal low enough? (I thought it was.) Or do you
          > think a more severe restriction (like about 0.5% DM or 100mg/100kcal) is
          > more
          > appropriate for a cat with elevated creatinine (which may indicate early
          > kidney
          > insufficiency, tho I wasn't clear whether Linda's cat has CRF)? Are cats
          > with
          > very restricted phosphorus intake at greater risk for metabolic acidosis
          > and/or
          > anemia?
          >
          > << Keeping the cat's phosphorus
          >
          > level as close to 4 as possible is important. >>
          >
          > Yes. A blood level around 4 mg/dL is important for all cats. Do you think
          > feeding a product with around 1% phosphorus DM would adversely affect the
          > blood
          > phosphorus level for most cats?
          >
          > << Interestingly, cooked skinless chicken thighs (obviously high in
          > protein)
          >
          > have about the same amount of phosphorus per 100 calories as K/D has per
          > 100
          >
          > calories. >>
          >
          > Also interesting is that cooked skinless chicken thighs contain about
          > twice
          > as much protein as k/d. 100kcal thighs = about 12.5g protein and 85mg
          > phosphorus. 100kcal k/d = about 6.5g protein and 80mg phosphorus.
          >
          > And just to follow up on the low-protein issue for those juggling kidney
          > and
          > heart disorders...there are a number of articles that cover the evolution
          > of
          > the reduced-protein theory and why it's now considered inappropriate. They
          > are
          > mostly about dogs, but the information is by and large applicable to cats,
          > who
          > have a higher dietary protein requirement than do dogs and an essential
          > need
          > for certain amino acids. (The first 2 had disappeared from the net for a
          > while, but are now available again in PDF format; click on the link below,
          > then
          > scroll to find the hot link for the article titles):
          >
          > 1. "Mythology of Protein Restriction for Dogs with Reduced Renal
          > Function,"
          > by Kenneth Bovee, DVM, MMedSc (UPenn) at
          > http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm
          >
          > 2. "Effects of Dietary Protein Intake on Renal Functions," by Delmar
          > Finco,
          > DVM, PhD (Univ of Ga) at
          > http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm
          >
          > 3. "Dietary Protein and the Kidney" by Patricia Schenck, DVM, PhD
          > (Michigan
          > State Univ) at
          > http://web.archive.org/web/20040205075757/http://www.cm-d.com/buckeye/tech_manual/8_28.html
          >
          > 4. www.dogaware.com/kidney.html
          >
          > // Rosemary
          >
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